Group-based interventions can promote better mental health in older adults

Niclasen J, Lund L, Obel C, Larsen L. Mental health interventions among older adults: A systematic review Scandinavian Journal of Public Health. 2018 May; 24(2):240-250.

Review question

•       Can interventions focusing on health promotion improve the mental health of healthy older adults over the age of 65 years old? 

Background

•       The World Health Organization estimates that approximately 15% of adults over the age of 60 suffer from a mental disorder.

•       Past studies have focused their evaluations of mental health interventions on objective measures such as difficulty with daily tasks and functional abilities.  However, many older adults who experience lower functional abilities still report having high levels of well-being. 

•       More focus should be placed on subjective measures of mental health such as self-reported psychological well-being and positive emotions in order to evaluate which interventions are truly beneficial for older adults.

How the review was done

•       A detailed search of two electronic databases for literature published between 2006 and 2016 was conducted. Studies with participants over the age of 65 years old that evaluated interventions promoting or preventing mental health problems were included in this review. The authors only included studies reporting findings in a Western cultural context (from Western Europe, North America, Australia and New Zealand). 


•       A total of 3,512 studies were identified in the initial database search, and 53 studies were included in the final review. 


•       This review was funded by the Danish Health Authorities.

What the researchers found

•       There was strong evidence to suggest that motivation to participate in an individual based intervention is of central importance to older adults. High-quality studies also found that adjusting the intensity of interventions to the participant’s level of physical, cognitive and social functioning was beneficial. 

•       Overall, group-based interventions and those containing social elements were found to have significant positive effects on participants' mental health, and highlighted that older adults need social connection. 

•       Two studies reported an advantage to home-care interventions with frequent contact between care providers and older adults.

Conclusion

•       This review found that motivation to participate, adjustment to individual abilities and frequent contact with care providers are all factors that can promote better mental health in older adults.

•       Group-based interventions were found to have the most positive effects on mental health but no specific intervention was recommended by the authors of this review.

•       More evidence is needed on the mental health of independent older adults of 65-75 years old since current studies focus on frail older adults or those with chronic conditions.